Top officials describe 'corrosive culture' in VA system

Jun. 30, 2014 - 08:14AM
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A damning analysis of the VA’s health care system was offered to President Obama Friday, with findings of a “corrosive culture,” low morale, poor management and widespread distrust between workers and supervisors — all driving systemic delays in health care for veterans.

In a report delivered to Obama on Friday by the acting VA secretary, Sloan Gibson, and Deputy White House Chief of Staff Rob Nabors, the president was told about a history of retaliation toward employees in the VA health care system who raise valid complaints. Obama also heard about a lack of accountability “across all grade levels.”

“We know that unacceptable, systemic problems and cultural issues ... prevent veterans from receiving timely care,” Gibson said in a statement late Friday. “We can and must solve these problems as we work to earn back the trust of veterans.”

The scandal over health care involves widespread manipulation of appointment records and delays in medical and mental health appointments for tens of thousands of veterans, some of whom waited months or never received treatment. The Justice Department has joined with investigators at the VA Inspector General’s Office to see whether criminal charges should be filed against medical officials.

Gibson said earlier this month that at least “some supervisors” are under criminal investigation.

In a released summary of the report provided to Obama on Friday, Gibson and Nabors portrayed a VA health care system badly in need of restructuring.

“In its most extreme manifestations, it has impeded appropriate management, supervision and oversight,” the report says. “There is a culture that tends to minimize problems or refuse to acknowledge problems at all.”

With 21 regional directors who oversee 150 hospitals and 830 outpatient clinics treating 6 million veterans a year, the sprawling system is rife with the practice of ignoring, minimizing or dragging its feet on directives coming out of VA headquarters, the report says.

The Veterans Health Administration is marked by “a belief many issues raised by the public, the VA leadership or oversight entities are exaggerated, unimportant or ‘will pass,’” the report says.

Meanwhile, the culture within the health agency “encourages discontent and backlash against employees.” The report notes that nearly one in four whistle-blower cases under review by the U.S. Office of Special Counsel, tasked with protecting federal employees who step forward, originate from the VA. It said 50 of these cases are currently pending with the Office of Special Counsel, all dealing with patient health or safety.

A broad inspector-general probe looking into the scandal is to conclude later this summer. But a quicker VA audit released earlier this month found that some level of record manipulation occurred at three out of four agency medical facilities.

According to VA data released last week, the agency has contacted 70,000 veterans whose appointments have been delayed and is working to get them quicker care.

The VA audit found that within the past 10 years, at least 64,000 veterans who came to the VA for health care were never treated. Some 13 percent of VA schedulers across the country were instructed by supervisors to falsify appointment records, and 8% said they kept unofficial lists of patients whose names were kept out of approved electronic records.

The scandal forced the resignations of VA Secretary Eric Shinseki, an undersecretary in charge of health care and the VA general counsel.

Acting Inspector General Richard Griffin said that while his investigators have identified 18 veterans who died awaiting care at a VA hospital in Phoenix, further efforts are underway to determine whether the health care delays caused those deaths.

The Office of Special Counsel wrote a letter to Obama on Monday complaining that VA medical officials glossed over problems raised by employees and failed to determine what harm might have been caused to veterans.

The agency neglected to acknowledge “the severity of systemic problems and (thus was prevented) from taking the necessary steps to provide quality care to veterans,” Carolyn Lerner, head of the Office of Special Counsel, wrote to the president.